How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $63.10 | Facility | None | $44.67 | $44.67 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $63.10 | Professional | None | $44.67 | $46.77 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $331.13 Typical High $354.81 | Facility | None | $95.50 | $331.13 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $588.84 | Professional | None | $52.48 | $83.18 | $588.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $12.88 Typical High $58.88 | Professional | RR · Rental | $5.75 | $12.88 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $95.50 Typical High $436.52 | Professional | UE · Used equipment | $42.66 | $95.50 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $128.82 | Professional | None | $58.88 | $58.88 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $144.54 | Professional | None | $67.61 | $95.50 | $144.54 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | None | $63.10 | $63.10 | $93.33 |
United Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $120.23 | Professional | None | $31.62 | $46.77 | $120.23 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $23.44 Typical High $31.62 | Professional | 52 · Reduced service | $22.39 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $12.59 | Professional | 53 · Discontinued | $8.91 | $9.33 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $9.33 | Professional | 55 · Aftercare only | $6.76 | $7.08 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $6.31 |
Where Georgia sits
The same service costs 4.4 times more in Hawaii than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 16th of 51
$77.62
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.